Sedentary Work Exerting up to 10 pounds (4.5 kg) of force occasionally and/or a negligible amount of force frequently or constantly to lift, carry, push, pull, or otherwise move objects, including the human body. Sedentary work involves sitting most of the time, but may involve walking or standing for brief periods of time. Jobs are sedentary if walking and standing are required only occasionally and other sedentary criteria are met.

Light Work Exerting up to 20 pounds (9.1 kg) of force occasionally and/or up to 10 pounds (4.5 kg) of force frequently, and/or negligible amount of force constantly to move objects. Physical demand requirements are in excess of those for Sedentary Work. Light Work usually requires walking or standing to a significant degree. However, if the use of the arm and/or leg controls requires exertion of forces greater than that for Sedentary Work and the worker sits most the time, the job is rated Light Work.

Medium Work Exerting up to 50 (22.7 kg) pounds of force occasionally, and/or up to 25 pounds (11.3 kg) of force frequently, and/or up to 10 pounds (4.5 kg) of forces constantly to move objects.

Heavy Work Exerting up to 100 pounds (45.4 kg) of force occasionally, and/or up to 50 pounds (22.7 kg) of force frequently, and/or in excess of 20 pounds (9.1 kg) of force constantly to move objects.

Very Heavy Work Exerting in excess of 100 pounds (45.4 kg) of force occasionally, and/or in excess of 50 pounds (22.7 kg) of force frequently, and/or in excess of 20 pounds (9.1 kg) of force constantly to move objects.

Job Classification

In most duration tables, five job classifications are displayed. These job classifications are based on the amount of physical effort required to perform the work. The classifications correspond to the Strength Factor classifications described in the United States Department of Labor's Dictionary of Occupational Titles. The following definitions are quoted directly from that publication.

Sedentary Work Exerting up to 10 pounds (4.5 kg) of force occasionally and/or a negligible amount of force frequently or constantly to lift, carry, push, pull, or otherwise move objects, including the human body. Sedentary work involves sitting most of the time, but may involve walking or standing for brief periods of time. Jobs are sedentary if walking and standing are required only occasionally and other sedentary criteria are met.

Light Work Exerting up to 20 pounds (9.1 kg) of force occasionally and/or up to 10 pounds (4.5 kg) of force frequently, and/or negligible amount of force constantly to move objects. Physical demand requirements are in excess of those for Sedentary Work. Light Work usually requires walking or standing to a significant degree. However, if the use of the arm and/or leg controls requires exertion of forces greater than that for Sedentary Work and the worker sits most the time, the job is rated Light Work.

Medium Work Exerting up to 50 (22.7 kg) pounds of force occasionally, and/or up to 25 pounds (11.3 kg) of force frequently, and/or up to 10 pounds (4.5 kg) of forces constantly to move objects.

Heavy Work Exerting up to 100 pounds (45.4 kg) of force occasionally, and/or up to 50 pounds (22.7 kg) of force frequently, and/or in excess of 20 pounds (9.1 kg) of force constantly to move objects.

Very Heavy Work Exerting in excess of 100 pounds (45.4 kg) of force occasionally, and/or in excess of 50 pounds (22.7 kg) of force frequently, and/or in excess of 20 pounds (9.1 kg) of force constantly to move objects.

Excision or Destruction of Duodenal Lesion

Related Terms

Duodenectomy

Endoscopic Excision of Duodenal Lesion

Esophagogastroduodenoscopy

Specialists

Gastroenterologist

General Surgeon

Comorbid Conditions

Immune system disorders

Factors Influencing Duration

Length of disability may be influenced by the type of procedure, type and extent of underlying condition, individual response to treatment, and presence of complications.

Medical Codes

ICD-9-CM:

45.30 -

Endoscopic Excision or Destruction of Lesion of Duodenum

45.31 -

Other Local Excision of Lesion of Duodenum

45.32 -

Other Destruction of Lesion of Duodenum

Overview

The duodenum is the first (proximal) segment of the small intestine that connects the stomach to the remainder of the gastrointestinal tract. The term duodenum means "12 fingers," which refers to its length of approximately 20 to 25 cm (12 fingers’ breadth). The duodenum is responsible for mixing the processed contents from the stomach with gall bladder, liver, and pancreatic enzymes, and then moving the contents into the rest of the small intestine (jejunum and ileum) through a series of muscular contractions (peristalsis).

Lesions of the duodenum may arise from the formation of ulcers (peptic ulcer disease), benign tumors, polyps, or cancerous growths (neoplasms). Inflammation of the small intestine (Crohn's disease) and abnormal intestinal reactions to grains such as wheat in the diet (celiac disease) are among conditions that can lead to cancerous growths in the upper gastrointestinal tract.

Various methods can be used to remove (excise) or destroy a localized area of diseased or damaged tissue in the duodenum. One common procedure involves use of a flexible, lighted viewing tube (endoscope) inserted into the mouth and through the esophagus and stomach to access the upper small intestine (esophagogastroduodenoscopy).

In cases involving growths that are unusually large, recurrent, or that could be malignant (cancerous), a lighted viewing tube (laparoscope) is inserted through a small incision in the abdomen to identify abnormal tissue. When a more expansive view of the target area is needed, a larger incision through the abdomen (open surgery) may be required for excision of abnormal tissue.

Reason for Procedure

While abnormal growths of tissue in the small intestine are usually benign, they may require removal if they grow large enough to obstruct the small intestine, gall bladder duct, or pancreas. Abnormal tissues such as duodenal ulcers or polyps may bleed or cause pain, requiring treatment. Removal of malignant tissue may be needed to prevent cancer from spreading (metastasizing) to other areas.

How Procedure is Performed

Upper endoscopy (esophagogastroduodenoscopy) is used to treat bleeding ulcers, and to successfully detect small, benign intestinal lesions in about 12% to 30% of cases (Terry). Prior to the procedure, the individual may require pain medication and a sedative. A thin, flexible fiber-optic viewing instrument with a controllable tip is inserted and guided through the multiple bends of the gastrointestinal tract. The scope's flexibility permits it to move forward, backward, and sideways, allowing the examiner to visually inspect interior structures. Endoscopic tools such as forceps and heating devices for sealing (cauterizing) wounds can be passed through a channel in the instrument. The instruments may then be used to remove or destroy abnormal tissue, as well as to take a biopsy.

In laparoscopic surgery, the individual is given general anesthesia. A small incision is made into the abdomen, where a small needle is placed to insufflate the abdominal cavity with carbon dioxide. This creates a space inside the abdomen in order to visualize the organs. A flexible viewing tube (laparoscope) is inserted for exploring internal structures. Once diseased tissue is identified, additional small incisions are made to allow access by long, narrow cutting instruments for excision of damaged tissue.

General anesthesia is used for open surgery, when a larger incision is made through the abdominal wall. Abnormal tissue is located and cut out (excised), or heat is applied through electrical current (electrocauterization) to destroy tissue. Additional tissue may also be removed along with the targeted growth or lesion (resection). Sutures or metal staples are used to close incision.

Prognosis

If diseased tissue is benign when removed from the small intestine, the individual can expect a full recovery. In cases of cancer of the small intestine, the prognosis following surgical removal may be poor particularly if the condition was not detected early.

Complications

Complications from open surgery can include bleeding and infection. If an endoscopic procedure is used, problems such as perforation of the intestine and bleeding may occur. Adverse responses to anesthesia may include irregular heartbeats or difficulty breathing.

Ability to Work (Return to Work Considerations)

Time off from work is necessary for the procedure and recovery period. Work place restrictions and special accommodations usually are not necessary after recovery from this procedure, except in cases of serious underlying conditions such as cancer. In these cases, the individual may require a transfer to other, less physically demanding duties.

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